PEMBlog

MAY 1, 2025

Well break down the virology, epidemiology, clinical presentation, and complications of Parvovirus B19. Parvovirus B19 is best known for causing fifth disease, but in certain patients it can lead to some serious complications like aplastic crises, fetal hydrops, or chronic anemia. So as you can see, this virus does a lot of stuff.

Complication 83

Complication Patient-Centered Patients Clinic 83

GeriPal

OCTOBER 13, 2022

And so there was a report in 2009 by the Institute of Medicine saying that we need to equip all of these individuals in caring for older person in an evidence based manner. There’s the complications associated with immune senescence, comorbidities, atypical clinical presentations. One of your articles addresses that.

Complication 97

Complication Patient-Centered IT Patients 97

GeriPal

MAY 19, 2022

Dr. Akhila Reddy and colleagues study looking at converting hospitalized cancer patients from IV hydromorphone to PO morphine, PO hydromorphone, or PO oxycodone. I know this is like, we’re talking about math and so that makes it all a little complicated, but think about it this way. The old table, 1.5 Drew: Not boxed.

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IT Patients Individual Relationship 139

33 Charts

OCTOBER 2, 2021

Why MyChart messages create a challenge for hospital systems So more contact and connection between doctors and patients seems like a good thing, right? Some of these Epic features can create the expectation of concierge-level service — a challenge at a time when hospitals are facing a global pandemic with crisis-level staffing.

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Patients IT Provider Family Doctor 75

GeriPal

JUNE 8, 2023

-@AlexSmithMD Additional Links: – Fingerstick monitoring in VA nursing homes (too common!) – Improving diabetes management in hospice – Continuous Glucose Monitoring complicating end of life care Transcript Eric: Welcome to the GeriPal podcast. This is Eric Widera. Alex Smith: This is Alex Smith. Is that your experience?

Diabetes 73

Diabetes Management Patient-Centered Families 73

GeriPal

JULY 19, 2024

What should we use to screen individuals? So we measure things like hospitalizations and ed visits and the like, and those data are a bit weaker, but they’re also, you know, I think they need to be contextualized in what, why we would even want to reduce hospitalizations right. Who should get it if anyone?

Screening 119

Screening Primary Care Patient-Centered IT 119

GeriPal

DECEMBER 14, 2023

More recently Sharon Kaufman ‘s book And a Time to Die described the ways in which physicians, nurses, hospital systems, and payment mechanisms influenced the hour and manner of patient’s deaths. Today Liz Dzeng discusses her journey towards studying this issue in detail. I guess the VA is federal though.

Hospital 125

Hospital IT Patient-Centered Patients 125

The Clinical Problem Solvers

APRIL 5, 2022

Dr. Margot Kushel is a Professor of Medicine and Division Chief at the Division of Vulnerable Populations at Zuckerberg San Francisco General Hospital and Trauma Center and Director of the UCSF Center for Vulnerable Populations and UCSF Benioff Homelessness and Housing Initiative. Push back against dehumanizing language.

Community 52

Community Patient-Centered Emergency Room Medical 52

GeriPal

JUNE 12, 2025

I didn’t know where they existed within the hospital. Eric 07:04 You actually created things like a curriculum for hospital medicine fellows in radiation oncology. Sometimes individuals have lung tumors that make it difficult for them to breathe. But radiation oncology was really more or less like a black box.

Patient-Centered 102

Patient-Centered Referral Patients IT 102

Doctor On Demand

APRIL 28, 2025

Unlike urgent care, which is suited for non-life-threatening conditions, the ER is designed to provide immediate, high-level care for severe complications from a sore throat, such as difficulty breathing, inability to swallow, or signs of a serious infection. Paramedics can provide life-saving treatment on the way to the hospital.

ER 52

ER Telehealth Primary Care Doctor Appointment 52

Vida Family Medicine

MARCH 28, 2024

Therefore, it is my practice not to prescribe intentional weight loss and instead focus on improving each patient's health with an individualized approach- by addressing underlying health conditions, social, and lifestyle factors affecting health- regardless of weight. But it is in my opinion the ethical and medically appropriate approach.

Diabetes 52

Diabetes Primary Care Physician Medical Patients 52

GeriPal

FEBRUARY 15, 2024

So it’s just a wide-opening lens that most of us never really get to see if we’re on the hospital-based side. I was like, “I have all these things I’m doing in the hospital to try to make people better and then I might be sending them right back to a big hazardous environment.”

Community 114

Community Transportation IT PCP 114

GeriPal

OCTOBER 20, 2022

And so there was a report in 2009 by the Institute of Medicine saying that we need to equip all of these individuals in caring for older person in an evidence based manner. There’s the complications associated with immune senescence, comorbidities, atypical clinical presentations. One of your articles addresses that.

Complication 52

Complication Patient-Centered IT Patients 52

Medical Xpress

JUNE 16, 2025

The law directs Texas universities and hospitals to lead the research. However, we do not guarantee individual replies due to the high volume of messages. "If we had said were going to do this for the homeless or the prison population, the Legislature might not have been as willing to get on board," he added.

Mental Health 52

Mental Health IT Specialization Medical 52

GeriPal

JANUARY 25, 2024

You can also listen to an audio interview with Alex and JAMA Deputy Editor Preeti Malani about this study and the other RCT of default palliative care for hospitalized older adults with noncancer serious illness published in the same issue. People had to be in the top 20th percentile of risk for being hospitalized or dying in the next year.

Patient-Centered 122

Patient-Centered IT Illness Patients 122

GeriPal

MAY 26, 2022

They argue that the current guidelines, which prioritize immunocompromised people and unvaccinated older people on the same level, should be re-done to prioritize the immunocompromised first, and additionally move up older vaccinated individuals or vaccinated persons with comorbidities. What’s wrong with that? Why not prioritize them?

Vaccination 87

Vaccination Individual IT Healthcare 87

GeriPal

NOVEMBER 14, 2024

And the big things that we think about as far as complications, so there, obviously the thing that comes to everybody’s mind is like fractures. Like there’s nothing we can do or do you feel like and we can talk about if so there are things that we can do to prevent falls and prevent the complications of those falls.

IT 124

IT Screening Patient-Centered Community 124

GeriPal

JUNE 30, 2022

Should she have an operation, and risk the pain, potential complications, and attendant delirium associated with the operation? Joel: The Brigham and Women’s Hospital likes me to say that too. Alex: And the Brigham and Women’s Hospital. And she was rushed to the hospital. She falls and breaks her hip.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

GeriPal

FEBRUARY 23, 2023

Imagine her hearing for the first time that you’re sick, that you’re hospitalized, that you’re in the ICU, and that you can’t make your own decisions? ” and the answer is no, that probably was more just about do you need anybody to support you kind of emotionally or during this hospital stay, just give information to.

Families 97

Families Family Patient-Centered IT 97

GeriPal

MAY 15, 2025

Prior podcasts on the ethics of nudging , and a different trial conducted by Kate and Scott in which the default for hospitalized seriously ill patients was to receive a palliative care consult. Many were community hospitals. The intervention was a negative study for the primary outcome, hospital length of stay. What is sludge?

Patient-Centered 116

Patient-Centered Hospital IT Illness 116

GeriPal

JULY 21, 2022

I’ve worked in hospital settings as an occupational therapist, inpatient rehab and outpatient rehab. Emmy: I was seeing people in the hospital setting, saying they had had a massive brain injury. Emmy: Ended up starting a program, outpatient at our hospital at the time. How did you get interested in this? Alex: Yeah.

Families 102

Families Family IT Diagnosis 102

GeriPal

JULY 11, 2024

So if one of my patients gets admitted, I also see them on the inpatient side of our hospital. I’ve seen patients post transplant when they start having complications. They are complicated. They’re complicated from a symptom standpoint. Can you come and be in our clinic once a week? So I go between.

Patient-Centered 109

Patient-Centered IT Patients Clinic 109

GeriPal

OCTOBER 26, 2023

Today we talk with Sarguni Singh, hospitalist-researcher at the University of Colorado, Ann Henshaw, Occupational Therapist who teaches at George Washington and works clinically at Georgetown, and Tamra Keeney, Physical Therapist-researcher at Mass General Hospital and Harvard Medical School. Tamra, welcome to the GeriPal podcast.

Patient-Centered 132

Patient-Centered Hospital Patients IT 132

GeriPal

JULY 28, 2022

Alex: And we are also delighted to welcome Areej El-Jawahri, who is an oncologist at Massachusetts General Hospital as well, who specializes in blood cancers. Jennifer: They have a meaningful impact on what happens to them during the hospitalization and after. They all self-identified as a hospital based practice.

Illness 110

Illness Hospital Patient-Centered Patients 110

GeriPal

APRIL 10, 2025

Today we discuss: Why the study was negative for the primary (hospitalization) and all secondary outcome (e.g. Tammie 03:04 Depends on how long they were pre-hospital. So that study was focused on patients admitted to the hospital. Was the clinician working frontline in those community hospitals? hospice use).

Patient-Centered 77

Patient-Centered IT Hospital Patients 77

PEMBlog

JUNE 2, 2025

Evaluation consists of lab studies, including CBC, CMP, BNP, troponin, UA, UDS, TSH with reflex to T4, and urine pregnancy test for individuals with a uterus.

Hypertension 75

Hypertension Management Physicals Lab Testing 75

GeriPal

MARCH 28, 2024

Kate: It was done in 10 hospitals, 17 ICUs in Atrium Health down in North Carolina. Asking clinicians to document prognosis did not change the primary outcome of hospital length of stay or really any of the secondary outcomes, which I’ll get into. Also the same hospital system? That’s when they got enrolled.

Consulting 115

Consulting Patient-Centered IT Patients 115

GeriPal

OCTOBER 19, 2023

Certainly SOME of those avoided hospitalizations, CPR, and ICU stays were due to documentation of those orders in the POLST. Additional links mentioned in the podcast: Recent JGIM article on POLST in California nursing homes, hospitalization, and nursing home care Karl’s GeriPal post on appropriate use of POLST Enjoy!

Patient-Centered 126

Patient-Centered IT Patients Illness 126

GeriPal

JANUARY 26, 2023

Second, as we discussed in last week’s podcast , older adults, particularly those in nursing homes, were far more likely to die than younger individuals. We lump everybody who’s 65 and older together, and then we don’t look at the individual characteristics of that person, so we fall into these patterns based on racial premises.

IT 91

IT Patient-Centered Healthcare Patients 91

GeriPal

MAY 25, 2023

Complicated grief? Health care system drives where you end up, which hospital, which state you live in. So if we said, like, did you make a decision while one of your loved ones was in the hospital, they would say, Oh, yeah, absolutely. Did the caregiver feel heard and understood? Did they have PTSD? Depression?

Community 95

Community IT Patient-Centered Primary Care 95

GeriPal

AUGUST 29, 2024

We must often deliver complex medical information that carries heavy emotional weight in pressured settings to individuals with varying cultural backgrounds, values, and beliefs. This is a complicated case. Gordon 41:13 The hospital is also on fire. I want you to be able to be in the hospital and be with your loved one.

IT 132

IT Illness Families Family 132

GeriPal

JUNE 9, 2022

Palliative care, in contrast, saw explosive growth in US hospitals. They were at the VA, but not so much at our main hub hospital where I trained. I do tend to focus in the hospital setting. That’s just not how the hospital works. Or the hospital, the intervention delivery is by who’s in practice.

Consulting 99

Consulting Patient-Centered Diagnosis Referral 99

GeriPal

NOVEMBER 7, 2024

Additional link to study with heatmaps of specific locations (hospital, nursing home, home) after initiating dialysis. -@AlexSmithMD ** NOTE: To claim CME credit for this episode, click here ** Transcript Eric 00:11 Welcome to the GeriPal podcast. He would go home, and then three weeks later he would be back in the hospital.

Management 116

Management Patient-Centered Patients IT 116

GeriPal

MARCH 6, 2025

Michaels Hospital in Toronto, and health justice activist. link] PEACH Good Wishes Program A program that provides meaningful gifts for unhoused individuals who are terminally ill. Michael’s Hospital in the Department of Family and Community Medicine. Today we talk with Naheed Dosani, a palliative care physician at St.

Healthcare 100

Healthcare IT Community Illness 100

GeriPal

MAY 4, 2023

We remember bucking the rules, figuring out who you are, hair on fire, feeling invulnerable, trying to figure out who you are – and now those adolescents are stuck in the hospital, with doctors and parents telling them what to do, having their autonomy crushed by the medical institution, realizing they’re not invulnerable. Abby: Yeah.

IT 83

IT Families Family Illness 83

GeriPal

FEBRUARY 13, 2025

Marie 03:08 So, living in Alabama, which is our palliative care desert in the south, there were no palliative care services in any of the small rural hospitals. We went to a hospital in Mississippi, one in Alabama, and one in South Carolina. The black individuals wanted to have a separate one from the white individuals.

Consulting 63

Consulting Community Patient-Centered Families 63

GeriPal

MARCH 3, 2022

A little over a decade ago, Ken Covinsky wrote a GeriPal post about a Jack Iwashyna JAMA study finding that older adults who survive sepsis are likely to develop new functional and cognitive deficits after they leave the hospital. To this day, Ken’s post is still one of the most searched and viewed posts on GeriPal. Eric: What was that paper?

Patient-Centered 96

Patient-Centered Patients IT Hospital 96